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Biomedical subjects

L Moore

Publications and source records attributed to L Moore.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Cytologic predictors of cervical intraepithelial neoplasia in women with an ASCUS Pap smear.

OBJECTIVE: To identify cytologic parameters on Pap smears of women with an atypical squamous cells of undetermined significance (ASCUS) diagnosis that could help cytologists to indicate whether a particular ASCUS case is most likely related to cervical intraepithelial neoplasia (CIN) grade 1 or 2/3. STUDY DESIGN: A total of 360 eligible women diagnosed with ASCUS and referred to the colposcopy clinic of Saint-Sacrement Hospital participated in the study. Eligible women were those aged 18-50 years, newly diagnosed with ASCUS, with no history of cervical biopsies or treatment, and not pregnant at the time of the visit. Colposcopically directed biopsies of lesions were obtained. All Pap smears were reviewed according to 36 different cytomorphologic criteria. The regression logistic model was used to estimate the odds ratios (ORs) for the associations between cytologic criteria observed in smears and the diagnosis of CIN made on biopsies. All cytologic criteria significantly (P < .05) associated with CIN were entered in the models, and a backward selection was done to determine independent cytologic predictors of CIN 1 and 2/3. RESULTS: Biopsies revealed that 22.2% of the study population had concurrent CIN. CIN I and 2/3 were identified in 61 (16.9%) and 19 women (5.3%), respectively. Clear perinuclear spaces (OR = 2.5, P = .002) and moderate nuclear atypia (OR = 4.4, P = .02) were two cytologic criteria independently associated with CIN 1. Four independent predictors of CIN 2/3 were identified: the presence of clear perinuclear spaces (OR = 5.9, P = .004), hyperchromasia (OR = 3.9, P = .04), moderate anisokaryosis (OR = 13.1, P = .01 and increased nuclear volume of metaplastic cells (OR = 5.1, P = .007). CONCLUSION: These observations may help cytologists to better categorize ASCUS lesions as intraepithelial ones and will also contribute to improving the Bethesda definition of ASCUS. Further studies are planned to validate these observations.

Adolescent↗
PubMedDate not supplied

Sudden and unexpected death in infancy associated with a single coronary artery.

Congenital anomalies of the coronary arteries, which are rare causes of sudden death in infancy and childhood, are becoming increasingly recognized. The majority of cases involve abnormal origins or courses of the coronary arteries, but some have absence of one of the major vessels. Sudden death occurring in a healthy-appearing 2-month-old boy is reported. An unexpected finding at autopsy was absence of the proximal right coronary artery, emphasizing the need for meticulous examination of the coronary artery system in all cases.

Coronary Vessel Anomalies↗
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Fatal paradoxical embolism to the left carotid artery during partial resection of Wilms' tumor.

An 8-year-old boy with an uncorrected ventricular septal defect, pulmonary stenosis, mental retardation, and gigantism died 24 hours after partial resection of a large right-sided Wilms' tumor. The presence of other abnormalities, including a small umbilical hernia and overgrowth of the external genitalia, raises the possibility that this case represents a variant of the Beckwith-Wiedemann syndrome. The typical facial features of Sotos' syndrome were not present. Gross examination of the surgical specimen revealed that tumor was present in the resected margin of left renal vein. Necropsy showed that death resulted from extensive cerebral infarction due to occlusion of the left internal carotid artery and its branches by tumor emboli. Paradoxical embolism had occurred during or soon after partial resection of the tumor mass due to passage of tumor fragments into the systemic circulation through the ventricular septal defect.

Carotid Artery Thrombosis↗
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Gastroesophageal reflux and sudden infant death syndrome.

The possible role of gastroesophageal reflux in the pathogenesis of the sudden infant death syndrome (SIDS) has not yet been clearly defined, although it does appear that infants with significant reflux are at greater risk of respiratory complications. A study was undertaken to characterize more precisely the histological features of esophageal mucosa taken from a series of infants who died of SIDS to determine the range of changes present. Full-length strips of mucosa were examined microscopically for reflux-related changes of basal layer hyperplasia, papillary elongation, and intraepithelial eosinophilia. Eight infants (21%) showed changes considered diagnostic of reflux esophagitis, 17 infants (45%) showed minor nondiagnostic changes, and 13 infants (34%) showed no histologic abnormalities. These findings demonstrate considerable morphological heterogeneity in a group of infants presenting with sudden and unexpected death. The absence of, or presence of only very minor, pathological alterations within the esophageal mucosae of 79% of infants suggests that reflux of a degree sufficient to cause diagnostic histologic changes is found in only a minority of infants presenting with SIDS.

Esophagitis, Peptic↗
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Lethal manifestations of neurofibromatosis type 1 in childhood.

Neurofibromatosis type 1 (NF-1), also known as peripheral neurofibromatosis or von Recklinghausen's disease, is a common inherited neurocutaneous syndrome. Complications of the disease are numerous and may be fatal, but because the frequency of potentially lethal complications increases with age, deaths from the disease are often thought to occur only in adults. Examination of autopsy records at the Adelaide Children's Hospital for the period 1952 to 1991 revealed four cases of children with NF-1. These cases illustrate a number of interesting pathologic features including a proliferative glial infiltrate involving the subarachnoid space, two primary gliomas within the same patient, gliomatosis cerebri, and sudden death due to massive intratumoral hemorrhage.

Abdominal Neoplasms↗
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Is postmortem examination useful in pediatric oncology?

Clinicians are often reluctant to request an autopsy for patients who have been extensively investigated during life, because they may believe that little additional information will be obtained. To examine whether this is the case, the autopsy records of pediatric oncology patients at the Adelaide Children's Hospital were reviewed. A total of 63 oncology patients died in the hospital during the period 1982-1991, 28 of whom underwent postmortem examination. Class I findings (those that would have altered management if they had been known during life) were found in 7 cases (25%). Major pathological findings that would not have altered management (class II) were found in 14.3% of cases. The most common class I findings were fungal infections with organisms such as Aspergillus or Candida species. Postmortem examination also revealed treatment-related complications in five patients, and in one case the diagnosis was made only at autopsy. This study confirms that postmortem examination can provide valuable new information even for patients who had been widely investigated in life and in whom the cause of death may appear obvious.

Adolescent↗
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Ectopic pregnancy.

This article discusses the aetiology of tubal ectopic pregnancy and the associated risk factors, methods of diagnosis and treatment options, so that nurses will be better informed and feel more confident when advising and nursing patients.

Female↗
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The experience of rape.

Explore the source record for details and available documents.

Adaptation, Psychological↗
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Establishing a smoking cessation support service.

Smoking cessation clinics are developing across the UK, prompted by a new drive to establish an evidence-based service for smokers who want to quit. Described here is the launch of a smoking cessation service for cardiac rehabilitation patients in an Oxfordshire hospital. The development of a smoking support group and the role of the nurse practitioner as facilitator are also described.

Health Promotion↗
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Referrals of participants in an urban WIC program to health and welfare services.

The Special Supplemental Food Program for Women, Infants, and Children (WIC) provides supplemental food, nutrition education, and referrals to available health and welfare services. Recipients are income-eligible pregnant and postpartum women, their infants, and their children who are younger than 5 years of age. Although studies have documented the nutritional benefits of the program, the extent to which WIC nutritionists help eligible women to obtain available health and welfare services, and the degree to which this referral activity promotes health, is largely unknown. The researchers examined the referral activity at one urban WIC clinic, but did not evaluate the outcomes. Of 1,850 persons seen, there were 762 referrals by WIC nutritionists for 597 persons at the Lawrence, MA, clinic during a 2-month period. Of the 597 persons, 494 (83 percent) were WIC participants and 103 (17 percent) were nonparticipants. The rate of referrals for WIC participants was 27 percent. Multiple referrals were common, with 127 people receiving more than one referral. WIC nutritionists at this site offered a variety of referrals to their clients. The majority of referrals (61.7 percent) were for supplemented food. Non nutrition-related referrals were to medical and dental services (20.5 percent), developmental and educational services (12.5 percent), and social services (5.4 percent). Non nutrition-related referrals for women included referrals for family planning, substance abuse, job training, teenaged parenting, and high school equivalency programs. Infants and children were referred for dental care, growth failure, the Head Start Program, kindergarten enrollment, early intervention, and protective services. WIC nutritionists are in an ideal position to evaluate a broad spectrum of health issues and to refer participants to health and welfare services because clients return regularly for vouchers and nutrition counselling. The authors conclude that WIC nutritionists should be given formal training in the evaluation of, and referral for, non nutrition related issues in order to maximize their health advocacy role.

Child Health Services↗
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[Immunotypes of Chlamydia trachomatis and the clinical picture of non-gonorrheal urethritis in men and cervicitis in women].

102 Chlamydia trachomatis isolates obtained from pregnant women and 42 isolates from man-consorts of women with chlamydial infection of cervix were immunotyped using a microimmunofluorescence (micro IF) with monoclonal antibodies kit (Washington Research Foundation, Seattle, USA). In both groups of patients the most common serovars were: E (37.3%) and D (24.6%) belonging to B-complex. Additional serovars noted were: F (11.3%), J (11.3%), I' (4.5%), I (3.5%, K (3.5%), G (2.8%) and H. Ba (both 0.2%). N. gonorrhoeae and/or T. vaginalis infections were more frequent from patients with B-complex Ch. trachomatis serovars (28/75 that is 37%) than C-complex Ch. trachomatis serovars (3/25 that is 12%).

Antibodies, Monoclonal↗
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Removal of higher molecular weight organic compounds by the granular activated carbon adsorption unit process.

The granular activated carbon adsorption unit process in drinking water treatment typically removes purgeable organic compounds for time periods on the order of a few weeks. Experimental evidence indicates that less volatile compounds of generally higher molecular weight than the purgeable fraction, but still detectable by gas chromatography, are efficiently removed for longer periods. Field data substantiate this. Explanatory mechanisms may include stronger adsorption affinities or biodegradation. Non-gas chromatographable, higher molecular weight materials such as humic acids, as measured by Total Organic Carbon (TOC) or trihalomethane formation potential, revert to lower removal efficiencies. Biodegradation may be responsible for a continued long term removal of a fraction of these materials.

Adsorption↗
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Validated extraction and cleanup procedures for polychlorinated biphenyls and DDE in human body fluids and infant formula.

As part of an epidemiology study, extraction methods and extract cleanup procedures were developed and validated for polychlorinated biphenyls (PCBs) and DDE, an ubiquitous metabolite of DDT, in human milk, blood serum, and infant formula. Studies included quantitative and reproducible recovery of total lipids, and reproducible and reasonably high recoveries of these chlorinated compounds from the human body fluids and infant formula, including levels of environmental health interest. An extensive quality control and assurance program was designed for use with these methods. Some validation work on serum was done using radiolabeled 14C-Aroclor 1254. Dilution assays were developed to permit use of a constant procedure, which should minimize variability in results. Methods are based on selected organic solvent extraction and column chromatographic cleanup techniques and quantitation by electron capture gas chromatography (EC/GC). Using these extensively researched extraction and cleanup methods, the limits of detection for GC measurements were 10.0 and 2.00 ppb for PCBs and DDE, respectively, in milk and 4.00 and 0.80 ppb in serum.

Animals↗